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Obamacare Tally: Florida Subsidies Average $3,000, But Some Families Complain of Costly Exclusion

| April 1, 2014

obamacare heartbeat

It’s beating. (Juhan Sonin)

A new study finds that 90 percent of Floridians who are enrolling in health plans under the Affordable Care Act qualify for tax credits amounting to an average of almost $3,000 apiece.

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And yet only one in four Floridians who qualifies for a subsidy had enrolled in a plan by March 1, the study said. This indicates that more than 1 million people in the state who qualify for the financial help had not yet taken advantage of it as of the date when the federal data were released — before procrastinators started a late-stage surge at and the toll-free line.

As of the beginning of this month the subsidies for Floridians totaled a whopping $1.17 billion, far more than any state except California, according to the report by Kaiser Family Foundation.

“While Florida officials haven’t exactly embraced Obamacare, people are signing up in large numbers in the state and receiving significant financial assistance with their insurance premiums,” co-author Larry Levitt told Health News Florida.

To be sure, Florida’s working-class, service-oriented economy, which is dominated by agriculture and tourism, has left close to 4 million uninsured. One in four of working age is uninsured, one of the highest rates in the nation.

But other states in the same fix haven’t enrolled as many. Levitt and others give a nod to the hard work of insurers and a network of community organizations that made good use of federal grants. It didn’t have to be invented; it was already in place.

The “Covering Kids and Families” program at University of South Florida in Tampa, led by Jodi Ray, has a successful track record of finding uninsured families and getting children enrolled in Florida KidCare — Medicaid or the state’s sliding-scale program for working families, Healthy Kids.

USF received a federal grant of $4.2 million to run the enrollment campaign in most of the state. USF in turn contracted with a dozen health-care programs that had experience with enrollment.

“They have the relationships,” Ray told the Associated Press. “They’re already trusted as credible sources of information about health coverage. That makes a big difference.”

It is not too late for those who are uninsured to take advantage of the tax credits. The official deadline is March 31, but those who begin the process of trying to enroll by then will be given a few more days to complete it, until April 15.

Sliding-scale subsidies are available to those with taxable family incomes from one to four times the poverty level, so the discounts would be greatest for those at 100 percent of poverty: about $11,500 for an individual and just under $46,000 for a family of four.

The subsidies are actually tax credits provided upfront so that enrollees don’t have to wait a year for reimbursement at tax time in 2015. They are calculated based on income, with consumers expected to contribute between 2 and 9.5 percent.

Floridians with incomes below the poverty level don’t qualify for the help, despite their poverty. The health law was written to give them coverage through the state’s Medicaid program with full federal funding, but Florida has declined to participate.

The tax credits are based on the second-lowest-priced “silver” plan (the categories, based on how much of a patient’s health costs they cover, are bronze, silver, gold and silver). Enrollees who choose a plan with a higher premium than the benchmark must pay the difference.

–Carol Gentry, Health News Florida

For A Family With Job-Based Insurance, Premium Subsidies Fall Far Short Of Promises


On Monday, the first open enrollment period for the new Affordable Care Act will close, and the opportunity to sign up for health insurance will not reopen again until November. For our family, President Barack Obama’s promise to make health insurance “affordable and available to every single American” has not come true.

In 2008, during the recession, my husband, Mike, accepted a buyout during the downsizing of his company and began a new career as a Texas public high school English teacher. Despite more than 30 years of experience in the publishing industry and five years now teaching, he earns just $37,000 a year. Combined with my small freelance income, that puts our family of three at 200 percent of the federal poverty level, an income level that qualifies other uninsured families for hefty premium and cost-sharing subsidies for policies sold on the health law’s online marketplace.

Good insurance coverage is important to us, especially because our daughter has a rare autoimmune disease. So we have opted for the PPO insurance plan offered through Mike’s school district, instead of the lower-cost HMO option. We pay more than $1,000 a month for the coverage, and that doesn’t include dental and vision insurance, which easily adds another $1,000 a year.

To try to save money, I got off his policy and purchased an individual plan that saves us about $100 a month.

When the ACA offered premium subsidies for the low-to-middle-wage worker, we began to have some hope of relief. We could not have been more wrong. Here’s why: Under Obamacare, people who get insurance through their employer are not qualified for subsidies if their work-place coverage is considered affordable—it cannot cost more than 9.5 percent their income—and it meets the minimum value standard—it must provide at least 60 percent of allowed medical expenses.

We’re paying nearly a third of our income for insurance, but the affordability standard is based on cost of coverage offered to the individual worker, no matter how much he pays in addition to that for spousal or family coverage. Mike’s insurance is considered very affordable, because the HMO offered to him alone costs just $420 a year, about 1 percent of his salary and well below 9.5 percent.

So I continue to look for full-time employment with benefits and keep my independent insurance.

Congress apparently built this exclusion into the health care law to prevent a mass exodus of workers from their employer-sponsored health plans. And the administration decided to interpret the law as referring to the cost of an individual’s coverage, despite lobbying from consumer groups and some Democratic lawmakers. However, offering some low-to-middle wage earners health insurance subsidies through tax credits, and not make it available to others like us, smacks of legalized disparity.

I wrote to the president and one of my senators, John Cornyn, a Republican, about the disparity.  The president responded with a form letter extolling the virtues of his new health care marketplace, and  Sen. Cornyn wrote back  condemning the atrocities inherent in the health law. I’m just guessing that neither of them ever read my letter or honestly considered my questions. Certainly, neither was prepared or willing to answer them.

While Sen. Cornyn boasted profusely for five paragraphs about his all-out-effort to repeal Obamacare (without ever addressing unsustainable health premium costs born by Texans before and after Obamacare), the president offered an equally profuse boast in the opposite direction. “The bottom line is that nobody is losing their right to healthcare coverage,” Obama wrote.

Right or left, red or blue, both sides of the power divide are conspicuously silent about the inequitable distribution of subsidies.

The operative question is: What exactly is a health care marketplace subsidy? It is essentially up-front tax relief and tax credit based on income, but only offered preferentially to those without employee health insurance that the government considers “affordable.” It does not matter that these subsidy-receiving workers are making just as much as, or more than, those who are ineligible for a subsidy by virtue of a bogus affordability formula.

One of the abiding principles of our great American democratic experiment is: No taxation without representation. A corollary of this principle would also seem to be: No tax relief without representation implying the attempt, at least, to safeguard the equal application of tax law.

I am reminded of the popular fairy tale, “The Emperor’s New Clothes.” The ACA has promised every American who doesn’t have health insurance a beautiful new suit of clothes. Some Americans may actually receive this new attire. The rest of America will help pay for it. While marketplace enthusiasts celebrate the ACA as a great success, low-to-middle income workers who already receive employee health insurance will see the ACA as it really is: window dressing, or successful enchantment, but a failed attempt to address some real disparities.

Kathie Platt is a freelance writer living in Beaumont, Texas.


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21 Responses for “Obamacare Tally: Florida Subsidies Average $3,000, But Some Families Complain of Costly Exclusion”

  1. A.S.F. says:

    I feel sorry for Kathie Platt and her family (although glad to see that this family at least DOES have healthcare which many people, before the ACA, did not.) It is saddening that she does not appear to realize how much she owes her predicament to those wonderful Republican representatives that she wrote her concerns to and who responded with (a) a form letter and (b) a propaganda tract extolling the evils of affordable healthcare. I do think that the President and Democrats in Congress caved in too much to special interest groups and intransigent Conservative Republican forces and that resulted in the watering down of our healthcare reform efforts. I think that is one of the reasons many families and individuals will continue to struggle under the new law. I hope this will change in the future. We will see.

  2. Yellowstone says:

    Republicans believe that if they keep trying (they’ve tried about 40+ times) to repeal ACA (an active and perfectly legal law), they can regain the House and Senate. At the same time forcing the 6 – 7 million people to go without health insurance. Nice!

    The Democrats on the otherhand want to take the ACA, with it’s flaws, and make it better.

    So, who are the progressives – who want progress?

    Who are those that want to impede progress and force folks into poor health?

    Vote this time . . .

  3. Rich Oliver Sr. says:

    My wife and I lost our health insuarnve we’ve had for the last 10 years on Jan 1 2014. Two gears ago we were paying $169.00 a month but it doubled last year and was going to $828.00 a month this year and paid for nothing no co pays and a $12,000 deductible. So we’ve searched for months talking to every agent we could find and all the plans and cost were the same. So I broke down and caaled one of the health care advocates from Obama are last week and he got our insurance for $334.00 a month with a $75.00 docotor co pay and low cost co pay on meds. It turned out we qualified for a $473.00 a month tax credit, that all the insurance agents told us we didn’t qualify for because it comes out of their commissions. So we were forced to comply because we dont have a choice. This new insurance is not as good as our old but it’s something.

  4. JL says:

    Obamacare does not do all it promises on t.v. I am fortunate to be under my husband’s insurance plan, however, my co-workers are not so fortunate. The insurance plan we have through our firm, the monthly rates went up, and also the deductibles that each co-worker must pay out of pocket. All because the AHA insisted all insurance companies increase their coverage. Now my co-workers are paying $4,000 per person per year out of pocket. One friend is a single mom, she signed up for the AHA, with the assistance she still has to pay $250 a month and have a $3,000 deductible. And she could NOT keep her doctors as promised. She would have had to pay so much more for the higher level of insurance. If anyone thinks that paying $3,000 per person per year is affordable, then you have more money than I do. That still doesn’t cover the entire cost, then each procedure is only covered at a certain percent.

    I would like to see everyone have medical insurance. But this was not the way to do it. I give it 3 years and some insurance companies will be out of business. This is not affordable to the average working citizen.

  5. Mystified says:

    In addition, you have to give up at least two rights in order to receive benefits:

    1. Your IRS file is no longer private

    2. Your spouse is made responsible for any IRS debt you may incur in the future because you WILL NOT receive benefits unless you file your tax return joint.

    With each new entitlement, Americans are losing more and more of their God-given freedoms.

    “Out of the sea (sea = people) rose a beast (beast = government designed by man which ignores God’s love and way He gave us to live in peace and prosperity). And they worshiped the beast.”

    They name this thing wrong. It should be called Yo Mama Care because it’s yo mama and her family who’s working who’s gonna pay for it all while we ignore, “If a man does not work, he should not eat,” as politicians demonize hard-working Americans to buy millions of votes by promising to create a socialist entitlement state at their expense. Everything is and has been already in place to care for the poor for years. It’s called Medicaid.

    While buying the the votes they alienated business owners, raided middle class incomes, reduced Senior health benefits, and plan to enslave the younger generation by making them pay for a majority of it.

    Bang-up job Washington!

  6. barbie says:

    The entire problem in Florida is *not* directly the fault of the ACA, it’s the fact that Rick Scott and the FL legislature refused to expand Medicaid. If Medicaid were expanded, a lot more people would have been helped. So many people that the ACA was meant to help still aren’t getting it. That’s just wrong.

    If there is an “up-side” to the fact that our state saw fit to stick it to us (because Obama!) it’s the fact that *since* FL didn’t expand Medicaid, you may be exempt from penalty this year, for not carrying the health insurance. So there’s that. Personally, I’d rather have the damned insurance. I’ve been putting off something that my regular doc can’t even help me with, it needs a specialist. Ridiculous that the Feds didn’t just open up Medicare/Medicaid to all of us, rather than create this new “thing”. They already had the infrastructure in place for it, all they needed to do was pass a few adjustments to it in the law, to allow for new age limits. That was *it*.

    But no. Because The Free Market Rules! That’ll fix everything! Remember when you vote in November, that Rick Scott could have made life a little easier for a bunch more Floridians, but he chose to try to score cheap political points instead. How many people in this state will die needlessly because of it?

    • A.S.F. says:

      Barbie, I agree with you!

    • Nancy N. says:

      The federal government DID try to open up Medicaid to a huge chunk of Americans, but it is a state administered program (unlike Medicare) and many states have chosen to tell the federal government to keep the money and leave millions of people uninsured.

      As for expanding Medicare to include everyone…that is essentially what is called the “single payer option”. While yes, it sounds like something that could be done relatively easily, it would have been political suicide for the Democrats faced with Republicans who are calling them socialist for the program they did enact. The ACA was a compromise. Not a perfect solution but you take what you can get and build from there.

  7. anoun says:

    I don’t care what number’s Mr Obama claimed he enrolled I know the numbers are all a lie.I don’t believe a word this administration says.Its funny they can tell you they signed up 7.1 million but can’t tell how many have paid or how many are from the people that have lost their insurance because of the affordable health care act. caused them to loose their insurance I believe they have counted anyone that has filled out the app on line but did nothing with it.I was getting a email every day telling me i have x amount of days to complete the sign up.If they know this they know the other numbers.This administration is great giving numbers when it favors them.When they don’t look good they seem to not know or have them or they are looking into getting them.I knew one way or another they would make the numbers.What a joke.Just more lies for the uninformed voter to believe.The only thing I believe has happen is yes the have signed up people who did not have or could not afford insurance.But at what cost.It caused the same amount or more people to loose their insurance.But what makes it worst is the people who lost their insurance are going to be paying for the ones who got insurance.Way to go Dems.Thats a great trade off.Wake up America its time for the Dems to go.If this Affordable Health care act is so great then why didn’t every Dem who voted for this bad law sign up for it .Why because they know its a bad law. and poor health care.They just want to look good.Why has Mr Obama made 29 changes to the law.Oh that’s simple.They all take effect after the 2014 elections.I know all the liberals are going to jump all over this.But when when you are one off the people who can’t afford the insurance and do not qualify for subsides.I don’t want to hear you line of bull about how every one deserves health care.I am a 12 year army vet and don’t even qualify for care under the Va.So if your are a Liberal and have not signed up for Obama I don’t care health care act even if you didn’t need to .You don’t have a clue.So keep on supporting this bad law.May be one day you know.

    • A.S.F. says:

      @Anoun says–And yet, FOX news has just publically apologized for their misleading graphic on the ACA enrollment numbers. They seem to end up apologizing A LOT for their, ahem, misinformation. But I’m willing to bet that you NEVER question them!

      • anoun says:

        Well your wrong again.I don’t watch Fox.Watch NBC.But at least the do apologize for giving misleading info.Unlike this administration.They just take the info and put some strange spin on it.

  8. m&m says:

    If you voted for this guy you can only BLAME yourself.. After he signed this destructive piece of crap you rewarded him by reelecting him.

    • A.S.F. says:

      This “destructive piece of crap” is one of the prime reasons Obama was elected and then re-elected. Maybe you should blame the majority of Americans for choosing to believe that all the citizens of our great country should be able to protect their health and safety. Shame on us!

  9. RHWeir says:

    Well, no subsidies here! My premium with my pension plan were up 46% for myself and my pension system kicked off spouses. My wife now pays over $300 per month for a private, ACA compliant plan. I’m 61 and a Democrat, I never voted Republican. I will vote for whoever will rescind the ACA and all aspects of Obamacare. By the way, there are a lot of people out there who did not get insurance because they could not afford it. No subsidies there either! And they’re mad as hornets.

  10. barbie says:

    Has everyone forgotten that “Obamacare” was modeled after RomneyCare? Do we seriously think *this* would be different under a President Romney?

  11. Genie says:

    @ RHWeir: No subsidies here, either. Insurance is still much too high and with such high deductibles, many are paying the federal government for nothing. And now most are paying more AND picking up the cost for those who have no insurance. When does it end?

    I’m with you on this one.

    FYI, a Bright House repairman was at my house today ad he is dealing with high blood pressure at a very young age. I asked if his work provided insurance and he said no, that it was waived by the administration until after the elections.

    Politicians would stop lying if they were voted out of office each time they did.

  12. RHWeir says:

    Forgot to mention the deductibles and co-pays we have now that we did not have before the ACA. Due to the co-pays and deductibles, both of us are ignoring our health. We only go for some select routine and some select preventive and hope the doctor does not upcode, and upcoding happens a lot around here. Anything else, we ignore it and hope for the best. So for us, the ACA is a disincentive to treat medical conditions that arise.

  13. A.S.F. says:

    How convenient it is to forget the tragic and desperate situations that people faced everyday BEFORE healthcare reform! Insurance companies could drop anyone at any time, for any reason. You could lose your job and pray to get COBRA at a proce you could afford…for year and half. Then, you could pray you would find a job with health insurance benefits. Before the ACA, we were all basically at the mercy of health insurance companies whose major concerns were the profits they would be reporting to their boards of trustees and directors and their shareholders. Lord knows, we could always trust them to do the right thing and take care of us! How COULD we even think for a second about wanting to change that infallible and compassionate system!

  14. Nancy N. says:

    To all the people whining about what the ACA did (or what you think it did) to your insurance, I’d like to say: consider yourself lucky that you have the luxury to whine about things like that. Many millions of Americans with chronic, even potentially fatal, conditions had no such option under the old system you are so desperate to return to.

    I have lupus with multiple complications. Until the ACA law went into effect on January 1st, I could not buy insurance on the private insurance market – AT ANY PRICE. Insurance agents literally hung up the phone on me in mid-sentence when they heard about my health history. I wasn’t worth their time to talk to.

    Since my health and caring for a child with a disability precludes me from keeping a regular work schedule, I am self-employed. This means no employer-sponsored health insurance. When the law went into effect on January 1st, I had been without insurance for two years. When you have a serious health condition, that is an eternity – and potentially life-threatening.

    Since January 1st, my husband and I have been insured again, with affordable premiums and deductibles thanks to ACA subsidies. It’s not the world’s best insurance but it’s a thousand times better than the nothing we had before. In the next few weeks both of us will start receiving the care we need for our chronic conditions.

    My 10 year old daughter is autistic and also has juvenile rheumatoid arthritis and scleroderma. She has been seriously ill the past few years. Her medical bills run more than $10,000 in the average month – often more. She is fortunately on a private policy that was purchased before she became ill. Before the ACA went into effect, we lived in terror of getting a cancellation letter from her insurance, a very common thing when you got sick on a private policy. Now, we don’t have to worry about that anymore.

    So you can whine and carry on about how your insurance changed, or your bill went up…but what you don’t realize is that if you actually HAD insurance to whine about – you were one of a lucky elite to begin with.

  15. A.S.F. says:

    @Nancy N says–And, Nancy N., that is about the gist of it. Conservative Republican politics has turned itself into a grotesque parody of itself by catering to the fears, selfishness and prejudices of some people as a ruse to benefit the insatiable greed and entitlement of the fortunate few who feel they should be able to rule the world…at any price. If masses of people suffer as a consequence, that’s something they can too easily justify.

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